HomeMy WebLinkAbout08-8132
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813) 780-0020
ANNUAL FIRE PROTECTION MAINTENANCE
8132
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
8132
FIRE PROTECTION MAINTENANC
FIRE-PROTECTION MAINTENAN E
COMMERCIAL
Book:
7/30/2008
25.00
25.00
7/30/2008 Phone:
FPM-FIRE ALARM- QUARTERL Y-PUBLlX
Name: TOWNVIEW RETAIL LLC
Address: 725 CONSHOHOCKEN STATE RD
BALA CYNWYD PA 190042102
610 667-5800
~~;o~
Chapter 633, Florida Statutes, authorizes the City to charge and collect user fees to pay for the costs of fire
prevention and protection related activities such as inspections, plan review, administrative fees, and other
costs related to the aforementioned.
Complete Plans, Specifications and Fee Must Accompany Application. Commencement of work without written approval of
the Fire Department's Fire Marshal or required permits or opening up for commercial activity without an approved final
inspection shall be charged double permit fee per day of operation or a minimum of $100.00, whichever is greater. All
work shall be performed in accordance with City Codes and Ordinances.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMNT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATIORNEY BEFORE RECORDING YOUR NOTICE
OF COMMENCEMENT."
...
P IT OFFICER
PERMIT EXPIRES IN 30 DAYS WITHOUT APPROVED INSPEcnON
CALL FOR INSPEcnON - 8 HOUR NOnCE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813-780-0041
. 813-7~0-0020
Date Received
.'Iler's Name
Owner's Address
City of.Zephyrhills Fire
Permit Application
#.rgt31-
Fax-813-78D-0021
7- 30- 0 Z' Phone Contact for Penn it
lJi""wVlV/eLV Rera.tI L L C Owner's Phone Number 1/)/:3
S'Ct;/Tz. ~E Pc~;rD1et LLC r~Ct:JY)5/J(J' ~C e
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117$'.:3 119)"tf /
ol fA
Fee Simple Titleholder Name
I Titleholder Phone Number
II
II
Fee Simple Titleholder Address
Job Address
Sub Division
Parcel #
Lot #
1..:3..r~~S'~/-"D/t?-O !7c7/lIJ-Oc) / /
tUb I f\1I'11~U r-KUIVI t"KUt"~K I Y I f\A NU II~~)
D Fire Alann Installation
D Fire Pumps
D Fire Works
D Flammable Application- ANNUAL
c==J Fuel Tanks
D Other: I
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D
D
D
o
D
D
Contractor
Signature
Address I
ELECTRICIAN
Signature
Address
PLUMBER
Signature
Address
MECHANiCAL!
Signature I
Address I
Controlled Bum
D
o
o
D
D
o
D 0
~~tte'('fy 0
D 0
D
o
o
Bio-Hazard Waste Storage - ANNUAL
Comm Exhaust Kitchen Hood/Duct
. Emergency Generator < 30 kw
Emergency Generator> 30 kw
Fire Protection Maintenance - ANNUAL
Sprinkler
Fire Alann
Hood Clean/Suppression
Fumigation Tent
Hazardous Material (Tier II or RQ Facility) ANNUAL
Hood Installation
LP/Natural Gas-Installation
LP/Natural Gas-ANNUAL Sale
Places of Assembly-ANNUAL
Recreational Bum
Sparklers
Sprinkler System Installations
Standpipes (Sprinkler Sys)
Torch Roofing
Waste Tire Storage ANNUAL
Valuation of Project
.-
Company
Registered
License #
~e.ctlrITY5t~c.e~
~ Fee Current _ N I
I
I
I
I
I
I
I
Y /N I
l
OTHER
Signature
Address I
, ...".""....:<i!<<<<w..
Directions:
Fill out application completely.
Owner & Contractor. sign back of application, notarized (Or, copy of signed contract with owner)
If over $2500, a Notice of Commencement is required (Mechanical work over $5000)
Supply two (2) sets of drawings with applicable documentation
Allow 10-14 days for review after submittal date.
Company
Registered
License #
I CP 1>0 t:!) I/O!. 3
I Y/N I Fee Current I Y/N
I
Y/N I Fee Current I Y/N
Y/N I Fee Current I Y/N
Company
Registered
License #
Company
Registered
License #
Company
Registered
Fee Current I
Y/N I
License #
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'. .
..NQT.JCE.OFDEED,RESTRICTIONS: The undersigned understands1hatthis permit m~ybesl:lbject to ~deed" restrictions"
-Which may be more restrictive .than County regulations. The undersigned assumes . responsibility for compJiance with any
applicable deed restrictions. . '. .. .
. UNLICENSED CONTRACTORS AND 'CONTRACTOR RESPONSIBILmES: If the owner has hired a contractor 0 or
. contractors to un~ertake work, they may be required to o. be licensed in accordanc~ with'state and local regUlations. If the
con~ctor is not licensed as required by law, both the owner and contractor may be .cited for a ':misdemeanor violation
under. state law. If the owner or intended contractor are uncertain as to.what licensing -requirements may apply for the
intended work, they are advised to contact the Pasco.County Building Inspection D.Msion-l:.icenslng Section at 727-847-
8009. . Furthermore, If the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions.of the "contractor Block" of this 'application for which they will be responsible. If you, as the owner sign as the
contractor, that may be an indication that he Is not properly licensed and is not entitled to permitting privileges in Pasco
County. .
CONSTRUCTION'UEN'LAW (Chapter713, Florida Statutes, as amended): 1fvaluation of work Is $2,500.00 or more;'1
certify that I, .the applicant, have been provided with a copy of the "Florida Construction Lien Law-Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the appliCant is someone
other than' the "owner", I.certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the "owner" prior to commencement.
CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and
... .n', ... "that.all.work-will be-done In.compliance.wlth--all.-applicable.-Iaws .regulatiRg.-cOAStnJctioA,..ZOAiAg.:and..land...........
development. Application is hereby made to obtain a perm.it to do work and installation as indicated. I certify
that no work or installation has commenced prior to issuance of a permit and that all work will be performed to
meet standards of all laws regulating .construction, County and City codes, zoning regulations, and land
developm~nt .regulations in the jurisdiction. I also certify .that I understand that the regulations of other
government agencies may apply to the intended work, and that it is my responsibility to. i~entify what actions I
must-take to be in compliance. .
If lam the AGENT fOR. THE OWNER, I promise in good faith to infonnthe owner of the permitting conditions'set forth :in
this affi.davit prior .to coiTlI:n~ncing construction. I understand that a separate permit may -be required for. electrical work,
plumbing, signs; wells,-pools, air conditioning, gas, or other installations not l?peclfically included in the application. A
Permit iS$u~d . shall:~ cons.trued to be a 'license to proceed with the work and not as auth~rity to violate, cancel, alter, or
setasidel any'provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from tl1ereafter
. requirlng.accmection of errors in pl~ns, construction or violations of any codes. Every J?6rmit issued shall become invalid
. .unl~'ifje:jiVork;aUt.h()rized'"by such permit is commenced Within six month~ o.f permit. Issuance, or If work authorized by
. .tfie:~frii.it.Js-$u$'p~rided or abandoned for a period ~ six (6) mo~ths after the time th~ work is commenced: An extension
,may.:J:Je requested, tn writing, from the Bulldlng OffiCIal.for a penod not t~ exceed mn~ty ~90) .da~ and'wllI demonstrate
, j~~~e ~iJse for tlie extension. If work ceases for ninety (90) consecutive days, the Job IS conSidered abandoned.
WARNiNG TO OWNER: YOUR fAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS ~~.. YO~R f'~9P.E.~1X:_ .IF~m1=.JIR,;rQ.g~;rAlfll~I"'A"'CJNG, CONSULT
.{ Vt(I1H..~~~~':1~~~ISS~-s.:~. . .W, ,CE"OF COMNlENCEMENT.
~~~:;~'aRAG~NT' ......__~.:.......:~..:....:......-.......-_.-:_-.-..-...--..._m-m---CONTRACTOR...----------...--.......-.~---........-..-.. ..' . ..... ..... ..... ........-.....-......
Subscribed and sWorn to {or aflirmed) before me this Subscribed and ~ to (or affirmed) before me this
woo"lslare per:;naI1y knoWn to me or hasJhaVe produced Who is/are personally known to me or haslhave produced
. as Identification. as Identification.
Notary Public
Notary Public
Commission No.
.Commlssion No.
Name of Notary typed, printed or stamped
Name of Notary typed, printed or stamped